How to Appeal a Medical Claim

Cigna-HealthSpring's Appeal Form is attached for your use. The Appeal Form is not required to file appeals with us, but it is provided for your convenience as an option to help capture the needed information to process your appeals. This form may be particularly helpful if you need to appeal many claims for the same reason – you can use just one form: Provider Claims Appeal Form

Requests for claim appeals must be made within 120 days from the date of remittance of the Explanation of Payment (EOP).

Within five (5) business days of receiving a written claim appeal, Cigna-HealthSpring will send an acknowledgement letter to the appealing provider. Provider Claim Appeals are resolved within thirty (30) days of receipt. Cigna-HealthSpring will send written notification of the resolution to the Provider. Providers can refer to the Cigna-HealthSpring Provider Manual for more information about claims filing and claims appeals.